Moderate Alcohol Drinking: Benefits and Risks

Hunter, Beatrice Trum, Consumers' Research Magazine

Moderate drinking has been defined as drinking that generally does not cause problems either for the drinker or for society. It is difficult to say what dose constitutes moderate drinking because of several factors.

Any given amount of alcohol may affect individuals quite differently. The pattern of drinking may determine alcohol-related consequences. For example, the effects of having one drink daily during a week has a different effect from seven drinks taken during one evening. Gender and age are factors, too.

Despite the complexity, attempts have been made to quantify what constitutes moderate drinking. Joint guidelines by the U.S. Department of Agriculture and the U.S. Department of Health and Human Services define moderate drinking as no more than two drinks a day for most men and one for most women. Generally, a standard drink consists of 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80-proof distilled spirits. Each of these drinks contains approximately the same amount of absolute alcohol - about 0.5 ounces (12 grams).

The different amounts for men and women in the guidelines reflect research findings that women, drinking an equivalent amount of alcohol as men, become more intoxicated. In part, this is due to a significant gender difference in the activity of an enzyme in stomach tissues that breaks down alcohol before it reaches the bloodstream. The enzyme in males is four times more active than in females. In addition, women generally have proportionately less body water and more fat than men. Alcohol is more soluble in water than in fat. Thus, any amount of alcohol becomes more highly concentrated in a woman's body than in a man's.

Age difference is another factor. Generally, the proportion of body fat increases with age. Therefore, the elderly should limit any alcoholic intake to one drink a day.

These guidelines exclude certain groups who, for different reasons, should not consume alcoholic drinks: women who are trying to conceive, or who are pregnant; those engaged in activities that require concentrated attention or skill, such as driving a car or operating machinery; those on medication; recovering alcoholics; and persons under the legal drinking age. Although not specifically excluded from the guidelines, alcoholic beverages are best avoided by those with certain medical conditions, such as peptic ulcer.

What are the benefits ascribed to moderate drinking.? Some studies suggest psychological benefits: stress reduction; promotion of conviviality as well as pleasant and carefree feelings; and decreased tension, anxiety, and self-consciousness. In the elderly, moderate drinking may stimulate appetite, promote regular bowel movements, and improve mood.

In addition, cardiovascular benefits have been ascribed to moderate drinking. It may decrease the mortality risk from coronary artery disease (CAD). In post-menopausal women, alcohol's apparent protective effect may be partly due to an alcohol-induced increase in estrogen levels.

Against these findings, other researchers have suggested that moderate drinking does not protect against CAD. They argue that studies showing higher mortality rates among abstainers result from including people who have stopped drinking because of ill health. Higher mortality among "sick quitters" skews results and explains the seemingly comparative longevity of moderate drinkers. However, studies of the sick-quitter effect do not appear to support that conclusion, or explain fully the apparent protective effect against CAD of moderate drinking.

There are some risks that might offset the possible benefits of moderate drinking. Some adverse results may occur at relatively low consumption levels.

Stroke. A review of epidemiologic studies concludes that moderate alcohol consumption may decrease stroke risks caused by blocked blood vessels. However, it may increase the potential risk of strokes caused by bleeding. …

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